Effect of early excision on patients with major thermal injury.

A randomized study was carried out to determine the effect on mortality of early massive excision of large burns. Fifty consecutive adult patients admitted to our hospital burn unit between December 1983 and January 1986 with 2 degrees and 3 degrees burns totaling at least 30% total body surface area (TBSA) were randomized on admission to one of two groups. The patients received either conservative therapy or early massive excision of all full-thickness burns. The two groups were similar in average size of burn but differed in their average age. In the patients with burns greater than 50% TBSA and no inhalation injury, mortality was decreased with early excision, which can be explained entirely by age differences alone. There was not a significant difference in length of stay, blood requirements, or in mortality in other groups of patients.